Predicting Second Stroke Risk

Having a second stroke soon after the first makes disability much more likely. A new tool helps predict the risk.

People who experience a second stroke within 90 days of having their first are more likely to suffer disabling effects after the second occurrence, making it critical for the medical community to have effective tools to predict which patients may be affected. Now, researchers at Harvard University Medical School and Massachusetts General Hospital have developed a new method to do just that.

"This is an important new tool because studies have shown that people who have a second stroke soon after a first stroke are more likely to die or have severe disability," said researcher Hakan Ay. "This tool can help doctors identify people who are at high risk of having another stroke and need immediate evaluation based on information typically available at the time of initial evaluation.”

In fact, having one or more of these risk factors predicted a second stroke in 96% of the almost 1,500 stroke patients followed in the current study. People who had all four risk factors were a whopping 40% more likely than others to suffer a second stroke.

Ay and his team pinpointed several risk factors that increase one’s odds for having a second stroke: these include data from brain scans, one’s history of having “transient ischemic attacks” (a.k.a. “mini−strokes), age, and the type of their first stroke. The more risk factors one racked up, the greater the likelihood of their having a second stroke.

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In fact, having one or more of these risk factors predicted a second stroke in 96% of the almost 1,500 stroke patients followed in the current study. People who had all four risk factors were a whopping 40% more likely than others to suffer a second stroke. Interestingly, classic stroke−predictors like smoking and high blood pressure played no role in predicting short−term risk.

The researchers are excited by the implications the findings will have in the clinical setting. "We currently don't have a well−developed tool for predicting short−term risk of early recurrent stroke, so this tool could help improve stroke care and outcome," Ay said. "For example, people at high risk of a second stroke can be immediately admitted to specialized stroke centers and given preventive treatment.”

The findings were published in the December 16, 2009 issue of the journal Neurology.